A new NHS improvement plan in Scotland has received a lukewarm response from nursing leaders in the country who questioned its deliverability.
Scottish health secretary Neil Gray has this week revealed the NHS Scotland Operational Improvement Plan, which sets out ways the government plans to “renew” the health service in the short term.
“Nursing staff will be left scratching their heads wondering just how the aspirations in this plan will be achieved in reality”
Colin Poolman
The plan, covering 2025 and 2026, is due to be followed by two others later this year that will outline the government’s strategic plans for health and social care in Scotland over the medium and longer term.
“Together these plans will progress reform to ensure long-term sustainability, reduce health inequalities, further harness the benefits of digital technology and improve population health outcomes in Scotland,” stated the government.
Most of the pledges in the Operational Improvement Plan were already mooted by Scottish first minister John Swinney during a speech on 27 January 2025.
They aim to reduce waiting times for patients, move more care out of hospitals and into the community and make better use of technology in the health service.
Among the promises is one to expand Scotland’s Hospital at Home service – which allows patients to receive inpatient care from their own homes – from 555 beds currently to at least 2,000 by the end of 2026.
The government said it was working with health boards to ensure plans were place by April 2025 to increase Hospital at Home capacity.
It added that it would ensure training and “quality improvement expertise” was available to support the development of existing staff and improve the standard of services.
The ambition is to establish pathways to enable direct referral into Hospital at Home from the ambulance service, flow navigation centres, emergency departments and frailty units.
The Operational Improvement Plan also includes a pledge to improve services for frail patients.
The government said it would make sure, by April 2025, that health boards had plans for developing new frailty services and expanding existing ones.
As part of this, by summer 2025, the government wants every core emergency department in Scotland to have specialist frailty teams in place.
“This will mean that frail, often older patients with complex needs, will receive the wrap-around care they need supporting them to return home or into a care setting as soon as possible ensuring better outcomes,” the government said in its plan.
“It will mean better care for these most vulnerable patients.”
Meanwhile, the government said NHS Scotland would deliver 150,000 extra appointments and procedures in 2025-26, compared with 2024-25, in order to tackle patient backlogs for surgery and diagnostic tests.
One way the government will make more appointments possible is by “optimising national and regional working across health board boundaries”, according to its new plan.
A new NHS app for patients in Scotland, called the Digital Front Door, is also due to be rolled out.
“It will mean better care for these most vulnerable patients”
Operational Improvement Plan
The app will be launched in Lanarkshire in December 2025, with plans for a national roll out in 2026.
The plan is being funded by the extra investment for health and social care made in the 2025-26 budget.
Much of the additional investment would go into staff recruitment, stated the plan.
Health secretary Mr Gray said: “This plan is ambitious but realistic, and builds on the incredible work of our amazing health and social care staff across our health boards, to deliver real change.”
However, the Royal College of Nursing (RCN) appeared to disagree that the plan was realistic.
Colin Poolman
Colin Poolman, RCN Scotland director, said: “The Scottish Government has proposed little that is new in this plan.
“It also lacks the detail nursing staff and the public need to assess whether or not it can be achieved or will solve the problems our health and care services are facing.”
He criticised the lack of reference to the nursing workforce needs or the work of the Ministerial Nursing and Midwifery Taskforce.
“More staff will be needed to deliver these improvements, yet we are hearing from nursing students that they are concerned they will not get a job when they qualify later this year because health boards are cutting recruitment,” warned Mr Poolman.
“All in all, nursing staff reading this will be left scratching their heads wondering just how the aspirations in this plan will be achieved in reality.”
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